Pharma spending on consumer advertising was largely flat in 2009, rising 1.9% to $4.5 billion over 2008 spend, according to data from The Nielsen Company. That's good news for media companies, suggesting that spending has hit bottom following two years of steep declines.

Taken altogether, the numbers barely budged in the two big drivers of spending, TV (+0.6%) and magazines (-0.6%), though big changes within those channels suggest continued pressure on pharmas to find efficiencies in their media buys.

“Overall, the combination of network TV and national magazines accounts for 62% of DTC spend,” said Nielsen SVP Fariba Zamaniyan. “In aggregate, that's down almost 6%, but the growth happening in that remaining 40% is just enough to offset that decrease.”

“Network TV is the more premium investment and advertisers in this space and others are going after airtime at the lowest cost,” said Zamaniyan. “Cable has a perception of efficiency because you can buy by day card and target niche audiences. The spending is half of what network is, but it's growing at a significant rate year-over-year.”

Part of what's driving that is the increasing length of pharma ads, owing to pressure from FDA to be more balanced in presenting risk and benefit information.

Ad spend on national magazines was steady, down 0.6% to $1.2 billion, and spending on local mags was down 20% to $490,000. Meanwhile, newspapers and radio bounced back from steep declines in spending, with newspaper ad spend up 11% altogether to $162 million and radio spend more than doubling to $46 million.

Spending on Spanish-language media exploded, with Spanish-language cable spend up 409% to $4 million and Spanish-language network spend up 294% to $29 million.

Internet ad spend rose 31% to $117 million. That's a big jump, even if it excludes search marketing and website development. But Zamaniyan thinks companies are still holding back on Internet advertising.

"Until the industry is confident that it can be evaluated from an ROI perspective, it won't get as much investment as TV, but in three years, that could change. It's really hard to tell right now until some of those metrics come into play."

Pfizer was the No. 1 pharma advertiser of 2009, with spend up 37% to $1.1 billion on strong support for brands like Lipitor, Viagra, Pristiq and Chantix. That puts the company head and shoulders above No. 2 industry spender AstraZeneca, which also increased DTC spend 37% in 2009 but spent a mere $371 million. Lilly was in third place, with spending down 11% to $350 million, and Merck took fourth place with spending down 16% to $345 million.